A leaflet to improve knowledge and attitudes to help-seeking for mental illness among Muslims

Help-seeking for mental illness is problematic among Muslim communities in Western countries. ^1,2 We set out to develop a leaflet on attitudinal and knowledge barriers to help-seeking for mental illness in UK Muslims, working with a local voluntary organisation (SMART), the Royal College of Psychiatrists (RCPsych) and the Muslim Council of Britain. In the leaflet, we addressed known barriers to help-seeking such as cultural and traditional beliefs, knowledge of and familiarity with formal services, perceived societal stigma, and the use of informal indigenous resources. ³ An Islamic religious leader checked the content for religious accuracy and we ensured the design was culturally consistent. A draft of the leaflet was piloted with a focus group of six Muslim men, then re-drafted using their feedback to produce the final version.

To evaluate the leaflet, we attended a London mosque at evening prayer time (Isha) and invited members of the congregation to complete a questionnaire before and after reading it. Twenty-five men aged 18-65+ volunteered; there were no women at the mosque at the time. All were Muslim UK residents: 32% Asian/Asian British Pakistani, 20% Asian/Asian British other, 44% other ethnicities combined, 4% gave no response. A statistically significant change was noted in response to two questions: ‘I would see a doctor if I felt very sad, worried, scared or was having unusual experiences’ (P = 0.039) and ‘I know what treatments are available for mental illnesses’ (P = 0.010). Furthermore, 72% of participants thought the leaflet helped them to understand mental illness better, 96% found it easy to read, 88% easy to understand and 72% felt more able to tell others about mental illness after reading it.

The leaflet was posted on the RCPsych website and results were collated from the online feedback. Respondents rated the leaflet on readability, usefulness, respectfulness and design on a scale from 1 (strongly disagree) to 5 (strongly agree). Overall, 103 respondents submitted feedback over a period of approximately 5 months: 10 service users, 6 patient relatives, 4 carers, 11 friends, 65 healthcare professionals, 8 healthcare students, 12 ‘others’. The mean score for ‘readable’ was 4.38 (88 responses); the mean score for ‘useful’ was 4.30 (94 responses); the mean score for ‘respectful’ was 4.11 (89 responses); and the mean score for ‘well-designed’ was 4.17 (89 responses), with a score of 4 meaning ‘agree’.

Although the evaluation was limited by a small sample size of men only and the lack of follow-up, we concluded that after reading the leaflet, participants assessed themselves as more likely to seek medical help if they were experiencing symptoms of mental illness and more knowledgeable about what treatments are available. They found the leaflet helpful in improving their understanding of mental illness, easy to read and understand, and thought it enabled them to tell others about mental illness. From the online feedback, respondents agreed that the leaflet was readable, useful, respectful and well designed.

The leaflet is available on the RCPsych website: www.rcpsych.ac.uk/healthadvice/problemsdisorders/leafletformuslimsonstress.aspx